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MATERNAL & CHILD HEALTH SERVICE • OKLAHOMA STATE DEPARTMENT OF HEALTH
OKLAHOMA PREGNANCY RISK ASSESSMENT MONITORING SYSTEM VOL 16 NO 1 SPRING 2012
Gestational Diabetes Among
Oklahoma Mothers
Introduction:
Gestational Diabetes Mellitus (GDM) is a glucose intolerance first diagnosed during pregnancy. GDM is associated with increased risks for adverse maternal and infant outcomes. Fetal and newborn risks include macrosomia, shoulder dystocia, birth injuries, hyperbilirubinemia, hypoglycemia, and respiratory distress syndrome. Risks for mothers include preeclampsia, cesarean delivery, and an increased risk of developing type 2 diabetes later in life.1, 2 Children of women with previous GDM also have an increased risk of developing childhood obesity, prediabetes, and type 2 diabetes. A Denmark study found that these children at 19-27 years of age had almost an eight-fold risk of prediabetes or diabetes.3
The Centers for Disease Control and Prevention (CDC) reported U.S. rates of GDM range from 2 percent to 10 percent of all pregnancies, and 5 to 10 percent of mothers are found to have diabetes postpartum.4 The risk for developing diabetes during the 10 to 20 years after a pregnancy with GDM increases to more than 60 percent for these mothers.4, 5
Risk factors associated with developing GDM include age (over 25), ethnicity (increased risk in Native Americans and those of Hispanic, Asian, or Chinese descent), obesity, family history of diabetes, previous delivery of a large-for-gestational-age infant (more than 9 pounds or 4,000 grams), an infant with an unexplained birth defect, previous history of glucose intolerance, and possibly women with a history of polycystic ovary disease.2 Diagnosis of GDM is made utilizing risk factors and oral glucose tolerance screening between 24-28 weeks of the pregnancy.6
Because GDM develops in the second half of pregnancy, it has not been associated with the increased
In Oklahoma:
• Almost one in ten Oklahoma mothers reported GDM or high blood sugar during their pregnancy.
• The risks were highest for mothers 30 years or older, those obese prior to becoming pregnant, multiparous women, and women living in lower income households.
• Prenatal counseling on types of food to eat during pregnancy was significantly greater for women with GDM (86.7% vs. 75.1% for non-GDM); however counseling on appropriate weight gain during pregnancy and exercise did not differ between GDM and non-GDM mothers.
• Compared to women in the normal or underweight BMI categories with GDM, overweight or obese women with GDM had higher rates of adverse outcomes, such as cesarean sections, high birth weight infants, and longer hospital stays for the mother after delivery.
risk for congenital anomalies that occur with preexisting diabetes. However, increasing rates of obesity have led to more cases of undiagnosed type 2 diabetes in women of childbearing age and a rise in the number of pregnant women with undiagnosed type 2 diabetes.4, 6
Methods:
The data for this study came from the Oklahoma Pregnancy Risk Assessment Monitoring System (PRAMS) survey. PRAMS is a population-based surveillance system designed to monitor behaviors of women before, during, and after pregnancy. The data represent all live births to Oklahoma residents. From 2004 to 2008, a total of 13,619 women were selected to participate in the survey and 9,829 (72.2%) of those women completed the surveys.

MATERNAL & CHILD HEALTH SERVICE • OKLAHOMA STATE DEPARTMENT OF HEALTH
OKLAHOMA PREGNANCY RISK ASSESSMENT MONITORING SYSTEM VOL 16 NO 1 SPRING 2012
Gestational Diabetes Among
Oklahoma Mothers
Introduction:
Gestational Diabetes Mellitus (GDM) is a glucose intolerance first diagnosed during pregnancy. GDM is associated with increased risks for adverse maternal and infant outcomes. Fetal and newborn risks include macrosomia, shoulder dystocia, birth injuries, hyperbilirubinemia, hypoglycemia, and respiratory distress syndrome. Risks for mothers include preeclampsia, cesarean delivery, and an increased risk of developing type 2 diabetes later in life.1, 2 Children of women with previous GDM also have an increased risk of developing childhood obesity, prediabetes, and type 2 diabetes. A Denmark study found that these children at 19-27 years of age had almost an eight-fold risk of prediabetes or diabetes.3
The Centers for Disease Control and Prevention (CDC) reported U.S. rates of GDM range from 2 percent to 10 percent of all pregnancies, and 5 to 10 percent of mothers are found to have diabetes postpartum.4 The risk for developing diabetes during the 10 to 20 years after a pregnancy with GDM increases to more than 60 percent for these mothers.4, 5
Risk factors associated with developing GDM include age (over 25), ethnicity (increased risk in Native Americans and those of Hispanic, Asian, or Chinese descent), obesity, family history of diabetes, previous delivery of a large-for-gestational-age infant (more than 9 pounds or 4,000 grams), an infant with an unexplained birth defect, previous history of glucose intolerance, and possibly women with a history of polycystic ovary disease.2 Diagnosis of GDM is made utilizing risk factors and oral glucose tolerance screening between 24-28 weeks of the pregnancy.6
Because GDM develops in the second half of pregnancy, it has not been associated with the increased
In Oklahoma:
• Almost one in ten Oklahoma mothers reported GDM or high blood sugar during their pregnancy.
• The risks were highest for mothers 30 years or older, those obese prior to becoming pregnant, multiparous women, and women living in lower income households.
• Prenatal counseling on types of food to eat during pregnancy was significantly greater for women with GDM (86.7% vs. 75.1% for non-GDM); however counseling on appropriate weight gain during pregnancy and exercise did not differ between GDM and non-GDM mothers.
• Compared to women in the normal or underweight BMI categories with GDM, overweight or obese women with GDM had higher rates of adverse outcomes, such as cesarean sections, high birth weight infants, and longer hospital stays for the mother after delivery.
risk for congenital anomalies that occur with preexisting diabetes. However, increasing rates of obesity have led to more cases of undiagnosed type 2 diabetes in women of childbearing age and a rise in the number of pregnant women with undiagnosed type 2 diabetes.4, 6
Methods:
The data for this study came from the Oklahoma Pregnancy Risk Assessment Monitoring System (PRAMS) survey. PRAMS is a population-based surveillance system designed to monitor behaviors of women before, during, and after pregnancy. The data represent all live births to Oklahoma residents. From 2004 to 2008, a total of 13,619 women were selected to participate in the survey and 9,829 (72.2%) of those women completed the surveys.